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EndoTODAY ³»½Ã°æ ±³½Ç


[PPI]

±×°ÍÀÌ ¾Ë°í½Í´Ù, ¼ÒÈ­±â ³»°ú Áø·áÇöÀå¿¡¼­ ³ª¿Â ¾à¸®Çп¡ °üÇÑ Áú¹®µé (°¡Å縯´ëÇб³ ¾à¸®Çб³½Ç ÀÓµ¿¼®)


[Selection of PPI based on relative potency]

Kirchheiner µîÀº intragastric pH¿¡ ¹ÌÄ¡´Â ¿µÇâÀ» ±âÁØÀ¸·Î PPIÀÇ relative potency¸¦ ºñ±³ÇÏ¿´½À´Ï´Ù (Eur J Clin Pharmacol 2009).

Eur J Clin Pharmacol 2009

Eur J Clin Pharmacol 2009

Dr. GrahamÀº 2018³â review¿¡¼­ Kirchheiner µîÀÇ ÀڷḦ ¹ÙÅÁÀ¸·Î PPIÀÇ relative potency¿¡ ´ëÇÏ¿© ¼³¸íÇÏ¿´½À´Ï´Ù. (PDF - Clin Gastroenterol Hepatol 2018). ¹Ì±¹¿¡¼­ »ç¿ë°¡´ÉÇÑ lowest available dose¸¦ ºñ±³ÇÑ ÀÚ·áÀÔ´Ï´Ù. Ilaprazole°ú dexlansoprazoleÀÌ ºüÁ®¼­ ´Ù¼Ò ¾Æ½±±â´Â ÇÕ´Ï´Ù.

Interchangeable use of PPIs based on relative potency
Drug at lowest available dosage in USAOmeprazole equivalent
Pantoprazole 20 mg4.5 mg
Lansoprazole 15 mg13.5 mg
Omeprazole 20 mg20 mg
Esomeprazole 20 mg32 mg
Rabeprazole 20 mg36 mg

Graham CGH 2018

Dr. Graham µµÇ¥´Â ¹Ì±¹¿¡¼­ÀÇ lowest avialable dose·Î µÇ¾î ÀÖ¾î ¿ì¸®°¡ º¸±â¿¡´Â ´Ù¼Ò ºÒÆíÇÕ´Ï´Ù. ±×·¡¼­ Á¦°¡ ´Ù½Ã ¸¸µé¾î º¸¾Ò½À´Ï´Ù. Omeprazole equivalent·Î Ç¥ÇöÇÏ¿© ¾àÇÑ °ÍºÎÅÍ °­ÇÑ ¾àÁ¦ ¼ø¼­·Î ¹è¿­ÇÏ¿´½À´Ï´Ù.

Interchangeable use of PPIs based on relative potency
Drug at available dosage in KoreaOmeprazole equivalent
Pantoprazole 20 mg4.5 mg
Pantoprazole 40 mg9 mg
Omeprazole 10 mg10 mg
Lansoprazole 15 mg13.5 mg
Esomeprazole 10 mg16 mg
Rabeprazole 10 mg18 mg
Omeprazole 20 mg20 mg
Lansoprazole 30 mg27 mg
Esomeprazole 20 mg32 mg
Rabeprazole 20 mg36 mg
Esomeprazole 40 mg64 mg

EsomeprazoleÀÌ »ó´ëÀûÀ¸·Î °­ÇÑ ¾àÀÌ´Ùº¸´Ï ¾î¶² ¿ë·®À» standard·Î ÇØ¾ß ÇÒÁö ³í¶õÀÌ ÀÖ¾î ¿Ô½À´Ï´Ù. ¿ì¸®³ª¶ó¿¡¼­´Â esomeprazole 40mgÀ» standard dose·Î »ï°í ÀÖÁö¸¸, ÀϺΠÀ¯·´ Àü¹®°¡µéÀº esomeprazole 20mgÀ» standard dose·Î °£ÁÖÇϱ⵵ ÇÕ´Ï´Ù. ±×·¸´Ù¸é ¿ì¸®³ª¶ó¿¡¼­ 1/4 dose·Î °£ÁֵǴ esomeprazole 20mgÀÌ ÀϺΠÀ¯·´Àü¹®°¡µé¿¡°Ô´Â half doseÀÎ ¼ÀÀÔ´Ï´Ù. Ç¥¸¦ º¸¸é esomeprazole 10mgÀº pantoprazole 20mg, lansoprazoe 15mg º¸´Ù´Â °­ÇÏ°í rabeprazole 10mgº¸´Ù´Â ¾àÇÑ relative potency¸¦ °¡Áö°í ÀÖ½À´Ï´Ù.


[PPI ȸ»ç ÀÚ·á]

Àϵ¿Á¦¾à. ¶óºñ¿¡Æ® rabeprazoleÀº bid Çã°¡°¡ µÇ¾î ÀÖ´Â ¾àÁ¦ÀÔ´Ï´Ù.

Àϵ¿Á¦¾à. ¶óºñ¿¡Æ®¿Í ¶óºñ¿¡Æ®µà¿ÀÀÇ ºñ±³


[2018-8-19] ¹ÚÂùÇõ ±³¼ö´Ô °­ÀÇ

Non-acid reflux related causes of refractoriness

[ÀÌÁØÇà ñÉ]

Life-style modification Áß Çϳª·Î üÁß Á¶ÀýÀÌ ¾ð±ÞµÇ¾ú½À´Ï´Ù. ±×·¯³ª üÁß Á¶ÀýÀº ÇØ¾ß ÇÒ ÀÏ ¿©·µ Áß Çϳª·Î »ý°¢ÇÒ¸¸Å­ »ç¼ÒÇÑ ÀÏÀÌ ¾Æ´Õ´Ï´Ù. Áö±Ýº¸´Ù ÈξÀ ´õ °­Á¶µÇ¾î¾ß ÇÒ °Í °°½À´Ï´Ù. Àú´Â ȯÀÚ¸¦ óÀ½ ¸¸³µÀ» ¶§ ´ÙÀ½ µÎ °¡Áö¸¦ ¸»¾¸µå¸³´Ï´Ù. "(1) À§½Äµµ¿ª·ùÁúȯÀº Ä¡·áµÇ´Â º´ÀÌ ¾Æ´Õ´Ï´Ù. ȯÀÚ¿Í Á¦°¡ ÇÔ²² ³ë·ÂÇÏ¿© Áõ»óÀ» °ü¸®ÇÏ´Â °ÍÀÔ´Ï´Ù. (2) üÁß °ü¸®´Â ³Ê~~~¹« Áß¿äÇÕ´Ï´Ù."

Refractory GERD¿¡¼­ ȯÀÚÀÇ compliance´Â ¹®Á¦°¡ ¾Æ´Õ´Ï´Ù. PPI°¡ ÀÚ½ÅÀÇ Áõ»ó¿¡ µµ¿òµÈ´Ù´Â °ÍÀ» ´À³¤ ȯÀÚ´Â Àǻ簡 ¸»ÇÏÁö ¾Ê¾Æµµ ¾àÀ» µå½Ê´Ï´Ù. Refractoriness´Â refractory GERDÀÇ ¿øÀÎÀÌ µÉ ¼ö ¾ø´Ù´Â ¸»¾¸ÀÔ´Ï´Ù. ½ÄÀü/½ÄÈÄ º¹¾à ½ÃÁ¡Àº À̷и¸Å­ Å« Â÷À̸¦ °¡Áö°í ¿ÀÁö ¾Ê½À´Ï´Ù. ½ÄÀü º¹¾à ½Ã°£À» ÁöÅ°Áö ¾Ê´Â ºÐ, ±×·¡¼­ refractory GERD°¡ µÈ ȯÀÚ¿¡¼­ ½ÄÀü º¹¾à ½Ã°£À» ÁöÅ°µµ·Ï ÇÔÀ¸·Î½á Áõ»óÀÌ °³¼±µÇ¾ú´Ù´Â Àӻ󿬱¸´Â ¾ÆÁ÷±îÁö ´Ü Çϳªµµ ¹ßÇ¥µÇÁö ¾Ê¾Ò½À´Ï´Ù. ¾î¼¸é ÀÇ»çµéÀÇ »ó»ó¼Ó ¹®Á¦ÀÏ ¼ö ÀÖ½À´Ï´Ù. Refractory GERDÀÇ ¿øÀÎÀ¸·Î ȯÀÚ Å¿À» ÇÏÁö ¸»¾Æ¾ß ÇÒ °Í °°½À´Ï´Ù.


[FAQ]

[2018-11-9. ÀÌÁØÇà È¥À㸻] ¿Ö PPI¸¦ ¹Ì±¹¿¡¼­´Â ½±°Ô ±¸ÇÒ ¼ö Àִµ¥ ¿ì¸®³ª¶ó¿¡¼­´Â ±×·¸Áö ¾ÊÀºÁö ¹°¾îº¸´Â ȯÀÚ°¡ °è¼Å¼­ ½Ã°£À» µé¿© Â÷ºÐÈ÷ ¼³¸íµå·È½À´Ï´Ù. Á¦µµ°¡ ´Ù¸¥ °ÍÀÔ´Ï´Ù. ÀÇ»ç ÀÔÀå¿¡¼­ º¸¸é ¹Ì±¹ Á¦µµ°¡ ´õ ÁÁ°í, ȯÀÚ ÀÔÀå¿¡¼­´Â ¿ì¸®³ª¶ó Á¦µµ°¡ ´õ ÁÁ½À´Ï´Ù. ±×·±µ¥ °¡Àå ÁÁÀº °ÍÀº ±× Áß°£ÀÏ °Í °°½À´Ï´Ù... Á¤µµ·Î ¸»¾¸µå·È½À´Ï´Ù.

[2020-12-22] Sodium bicarbonate¿Í esomeprazole º¹ÇÕÁ¦ Esoduo ¿¡¼Òµà¿À °ü·Ã ÀÎÅͺ並 ÇÏ¿´½À´Ï´Ù.

PDF

[2022-4-24] ¾î´À cardiologistÀÇ PPI ó¹æ·Ê

Àϵ¿Á¦¾à °æÁÖ ½ÉÆ÷Áö¾ö


[References]

1) GERDTODAY - À§½Äµµ¿ª·ùÁúȯ Áõ·Ê ÅäÀÇ

2) GERD ÃÑ·Ð

3) GERD and PPI FAQ

4) PPI ºÎÀÛ¿ë

© ÀÏ¿ø³»½Ã°æ±³½Ç ¹Ù¸¥³»½Ã°æ¿¬±¸¼Ò ÀÌÁØÇà. EndoTODAY Endoscopy Learning Center. Lee Jun Haeng.